Fall brings cooler mornings, changing leaves—and often a confusing mix of sneezing, coughing and congestion. Fall allergies are active at the same time that colds, influenza and COVID-19 begin circulating more widely. Because these conditions share symptoms, it is not always easy to know what is making you or your child feel sick.
Symptoms offer useful clues, but not always a definite answer. Flu and COVID-19, in particular, may look very much alike. Testing and a conversation with a healthcare provider may be needed, especially when someone is at greater risk of serious illness.
Look for the pattern
Allergies are more likely to cause repeated sneezing, an itchy nose or throat, and itchy, watery eyes. Nasal drainage is often clear. Symptoms may appear after being outdoors, mowing grass or spending time around a particular trigger. Allergies do not cause a contagious illness and usually do not cause fever, chills or significant body aches.
A common cold often develops gradually, perhaps beginning with a scratchy throat followed by a stuffy or runny nose, sneezing and a mild cough. Adults may have little or no fever. Most colds begin improving within several days, although congestion or a cough can linger.
Flu often comes on more suddenly and can cause fever or chills, headache, pronounced fatigue, body aches and cough. COVID-19 can cause many of the same symptoms, as well as shortness of breath, nausea, diarrhea or a change in taste or smell. Not everyone with flu or COVID-19 develops a fever, so the absence of fever does not rule either one out.
When testing may help
You cannot reliably distinguish flu from COVID-19 by symptoms alone. Testing can guide treatment and decisions about protecting others. Consider it particularly after a known exposure or if you spend time around older adults, infants or people with weakened immune systems.
Contact your healthcare provider promptly if you are 65 or older, pregnant, immunocompromised or living with a chronic condition such as asthma, lung disease, heart disease or diabetes. Antiviral medications are available for flu and COVID-19, but work best when started soon after symptoms begin.
When home care is reasonable
Mild symptoms can often be managed with rest, fluids and appropriate over-the-counter medication. Read labels carefully and ask a pharmacist or healthcare provider before using a new product, particularly for young children or if you take prescription medicine or have a chronic condition. Antibiotics do not treat colds, flu or COVID-19 because these illnesses are caused by viruses.
If you may have a respiratory virus, stay home and away from others while ill. You can generally return to normal activities after symptoms have improved overall for at least 24 hours and you have been fever-free for 24 hours without medication. For the next five days, consider added precautions such as improving ventilation, wearing a well-fitting mask and keeping some distance from people at higher risk.
Know when to seek help
Call your healthcare provider if symptoms worsen rather than improve, a fever or cough goes away and then returns, you cannot keep fluids down, or a chronic condition becomes harder to manage. Infants younger than 12 weeks should receive prompt medical attention for any fever of 100.4 degrees or higher.
Seek emergency care for trouble breathing, persistent pain or pressure in the chest, new confusion, inability to wake or stay awake, bluish or gray lips or face, severe weakness, signs of dehydration or any other symptom that is severe or frightening.
Keeping recommended vaccines up to date, washing your hands, covering coughs and sneezes, and staying home when sick can reduce the spread of respiratory illnesses. Pay attention to how you feel and seek advice early when you are unsure. A timely call may provide reassurance—or help you begin treatment while it can do the most good.
Dr. Megan Thomas is the newly appointed Chief Medical Officer of the Community Health Center of the New River Valley and sees patients in Christiansburg, Dublin and at the Pulaski County High School Student Health Center. She is board-certified in Internal Medicine and Pediatrics and has extensive experience as a practitioner, teacher and mentor. CHCNRV provides medical, dental and behavioral health services in Christiansburg, Dublin, Pearisburg and at Pulaski County High School. Learn more at chcnrv.org or call 540.381.0820.
